Tesamorelin is a synthetic version of growth hormone-releasing hormone with a small chemical addition that makes it more stable. Sold as Egrifta, it is FDA-approved for one use: reducing excess abdominal fat in adults with HIV and lipodystrophy.
Approved drug exists
WADA prohibited
Human trials
Also known as Egrifta, Egrifta SV, Egrifta WR, TH9507
Tesamorelin is the full 44-amino-acid sequence of human growth hormone-releasing hormone (GHRH) with a short fatty chain (a hexenoyl group) attached to the first amino acid, according to the FDA prescribing information. The addition makes it more stable than natural GHRH. It signals the pituitary to release growth hormone, which in turn raises IGF-1.
It was developed by Theratechnologies under the code TH9507 for a specific problem: some people with HIV on antiretroviral therapy build up fat deep inside the abdomen (visceral fat). After a phase 2 dose-finding trial (Falutz 2005), two phase 3 trials (806 participants in the pooled analysis) showed less visceral fat than placebo (Falutz 2007; Falutz 2010; Falutz 2010). The FDA approved it in November 2010. Newer formulations, Egrifta SV and Egrifta WR, use different vial strengths and doses from the 2 mg daily dose used in the original trials.
Unlike most peptides on this site, tesamorelin has large, placebo-controlled trials behind it, including independent ones funded by the US National Institutes of Health. All of the large trials are in people with HIV; studies in other groups are small.
Type: synthetic GHRH analogue, 44 amino acids plus a hexenoyl group.
Studied for: visceral (deep abdominal) fat and liver fat in people with HIV; smaller studies in type 2 diabetes and in older adults' thinking skills.
Strongest evidence: two phase 3 randomised controlled trials (806 people in the pooled analysis) plus later controlled trials on liver fat.
Legal status: FDA-approved prescription drug for one indication; prohibited in sport by WADA.
02
Tesamorelin dosing in the FDA label
The approved drug has an official dosing schedule in its FDA label. It is shown here as published, with its source.
Dosing from the current FDA-approved label of each drug.
Drug
Approved use
Dosing in the label
Egrifta SV (2 mg vial)
Reducing excess abdominal fat in adults with HIV and lipodystrophy
1.4 mg under the skin of the abdomen once daily: one vial mixed with 0.5 mL of the supplied sterile water, 0.35 mL injected right away, the rest discarded.
Egrifta WR (11.6 mg vial)
Same use as Egrifta SV
1.28 mg under the skin of the abdomen once daily: one vial mixed with 1.3 mL of the supplied bacteriostatic water gives 0.16 mL doses for 7 days. Not interchangeable with Egrifta SV.
Schedules reported for this peptide, with the syringe measure for each step and the supplies each one takes. Reported use is not evidence that a schedule works or is safe, and none of this is medical advice.
Phase 3 amount, once daily
Subcutaneous injection, once a day
From clinical trials
The dose escalation used in published human trials, worked out for a research vial. Worked out with a 10 mg vial + 3 mL bacteriostatic water (3.33 mg/mL, 33.3 mcg per unit).
Amounts as reported, with the syringe or spray measure for the vial below. Not a recommendation.
Period
Amount each time
U-100 units
Volume
Week 1 on
2 mg
60
0.6 mL
Minimum supplies, worked out from the amounts above. Add a margin for losses.
Item
8 weeks
12 weeks
16 weeks
Injections
56
84
112
Total peptide
112 mg
168 mg
224 mg
Tesamorelin vials (10 mg)
12
17
23
Bacteriostatic water
36 mL
51 mL
69 mL
Water bottles (10 mL)
4
6
7
U-100 insulin syringes
56
84
112
Alcohol swabs (boxes of 100)
112 (2)
168 (2)
224 (3)
04
Tesamorelin doses used in studies
The dose each published study gave its participants, copied from the paper. Not dosing instructions; animal doses do not convert directly to people.
At a glance: 9 studies report a dose (9 in people).
Doses used in human studies
Falutz J 2007: 2 mg once daily (Subcutaneous, once daily; 26 weeks)
Falutz J 2005: 1 mg or 2 mg once daily, or placebo (Subcutaneous, once daily; 12 weeks)
Falutz J 2008: 2 mg once daily, or placebo after re-randomisation (Subcutaneous, once daily; 26-week extension (52 weeks in total))
Falutz J 2010: 2 mg once daily, or placebo (2:1) (Subcutaneous, once daily; 6 months, plus a 6-month blinded extension)
Falutz J 2010: 2 mg once daily, or placebo (Subcutaneous, once daily; 26 weeks, plus a 26-week extension)
Stanley TL 2014: 2 mg once daily (n=28), or placebo (n=22) (Subcutaneous, once daily; 6 months)
Stanley TL 2019: 2 mg once daily, or placebo; then 2 mg daily open-label for all (Subcutaneous, once daily; 12 months, plus a 6-month open-label phase)
Clemmons DR 2017: 1 mg or 2 mg, or placebo (Subcutaneous; 12 weeks)
Baker LD 2012: 1 mg/day, 30 minutes before bedtime, or placebo (Subcutaneous, nightly (self-injected); 20 weeks, plus 10-week washout)
Every study
Doses as reported by each study. Not a recommendation.
What has been studied, by type of evidence. A result in animals or cells is a reason to study something in people, not proof that it works in people.
In humans
Summarised
The main human studies, all randomised and placebo-controlled unless stated:
Phase 2 dose-finding: in 61 people with HIV and central fat, 2 mg daily for 12 weeks reduced trunk fat by 9.2% vs a 0.8% rise with placebo. Visceral fat fell 15.7%, but this was not statistically different from placebo (Falutz 2005).
First phase 3 trial: 412 people; 2 mg daily for 26 weeks reduced visceral fat and improved lipid levels compared with placebo (Falutz 2007). In the 26-week extension, the reduction was maintained at about 18% over 52 weeks, but fat returned after stopping (Falutz 2008).
Second phase 3 trial: 404 people; visceral fat fell 10.9% vs 0.6% with placebo at 6 months, with no change in glucose measures. Again, the gains were rapidly lost in those switched to placebo (Falutz 2010).
Pooled phase 3 data: across 806 people, the placebo-adjusted reduction in visceral fat was 15.4% at 26 weeks, with no meaningful change in fat under the skin and a mean IGF-1 rise of 108 ng/ml (Falutz 2010).
Liver fat: in 50 people with HIV, 6 months reduced visceral fat and liver fat; fasting glucose rose at 2 weeks but not by 6 months (Stanley 2014). In an NIH-funded trial in 61 people with HIV and fatty liver disease, 12 months reduced the liver fat fraction by 4.1 percentage points more than placebo (Stanley 2019).
Type 2 diabetes: in 53 people with type 2 diabetes (without HIV), 12 weeks did not change insulin response or blood sugar control (Clemmons 2017).
Thinking skills in older adults: in 152 adults aged 55-87, 1 mg nightly for 20 weeks had a favourable effect on a combined cognitive score, mainly executive function. Adverse events were reported by 68% on tesamorelin vs 36% on placebo (Baker 2012).
A 2026 meta-analysis of five randomised trials in people with HIV confirmed lower visceral fat, trunk fat, liver fat and waist size, and higher lean mass, with side effects such as joint pain, muscle pain, tingling and injection-site redness (Badran 2026). In short: in people with HIV, tesamorelin reliably reduces visceral fat while it is used, and the effect fades after stopping. Whether this lowers heart disease or other hard outcomes has not been shown, and the evidence outside HIV is limited to small trials.
In animals
Nothing yet
No summary in our library yet. We only publish one after checking it against the original papers.
In cells (in vitro)
Nothing yet
No summary in our library yet. We only publish one after checking it against the original papers.
Proposed mechanisms from cell and animal studies. A plausible mechanism is not evidence of an effect in people.
Tesamorelin works through the body's own growth hormone system rather than replacing growth hormone:
GHRH receptor in the pituitary: it acts like natural GHRH, so the pituitary releases more growth hormone and IGF-1 rises; in the phase 3 trials mean IGF-1 rose by about 108 ng/ml (Falutz 2010).
Selective loss of deep abdominal fat: visceral fat fell while fat under the skin of the abdomen and limbs was largely unchanged in the main trials (Falutz 2010; Falutz 2010).
Liver fat: fat in the liver fell alongside visceral fat in people with HIV (Stanley 2014; Stanley 2019).
07
Reconstitution
How concentration changes with the amount of liquid added. A U-100 insulin syringe holds 1 mL in 100 units, so each unit is 0.01 mL. Step-by-step guide.
Step by step
Wash your hands and work on a clean, uncluttered surface. Let a refrigerated vial reach room temperature so the stopper is easier to pierce.
Wipe the rubber stopper of the peptide vial and of the bacteriostatic water with a fresh alcohol swab, and let them air-dry.
Draw the chosen volume of bacteriostatic water into a sterile syringe. With 2 mL, a 10 mg vial ends up at 5,000 mcg/mL, or 50 mcg per U-100 unit.
Insert the needle through the stopper and let the water run slowly down the inside wall of the vial, not straight onto the powder.
Swirl or roll the vial gently until the powder dissolves. Do not shake it: foaming can damage some peptides.
Check the solution against the light. It should be clear; cloudiness or particles mean something is wrong with the vial or the water.
Write the date and the volume of water on the label. Every unit calculation later depends on that volume.
Store the reconstituted Tesamorelin vial in the refrigerator, away from light.
Concentration by volume
Concentration after adding the liquid, and how much peptide each U-100 unit (0.01 mL) holds.
Arithmetic only. It assumes the vial holds exactly what the label says.
Concentration
5,000 mcg/mL
Per U-100 unit
50 mcg
Volume for your amount
—
08
Measuring with a U-100 syringe
What each mark on an insulin syringe holds once the vial is mixed. This is arithmetic, not a dose.
Reading a U-100 syringe: how much peptide each mark holds in a 10 mg vial mixed with 2 mL. Not a dose.
Syringe mark
Volume
Peptide in that volume
5 units
0.05 mL
250 mcg
10 units
0.1 mL
500 mcg
20 units
0.2 mL
1 mg
25 units
0.25 mL
1.25 mg
50 units
0.5 mL
2.5 mg
100 units
1 mL
5 mg
A U-100 insulin syringe holds 1 mL in 100 units, so each unit is 0.01 mL. The marks measure volume, not peptide.
Syringes come in 0.3 mL (30 units), 0.5 mL (50 units) and 1 mL (100 units) sizes. The smaller ones have finer marks and are easier to read for small volumes.
Read the volume at the top edge of the plunger's rubber seal, at eye level.
Tap out air bubbles before reading: a bubble takes up volume and makes the reading wrong.
Use a new sterile syringe and needle every time, and dispose of them in a sharps container.
09
Supplies
What reconstituting and measuring a vial takes.
The peptide vial, with its certificate of analysis (COA) for that batch. See how to read a COA.
Bacteriostatic water (water with 0.9% benzyl alcohol), which keeps a multi-use vial from growing bacteria. Sterile water has no preservative.
Sterile syringes to add the water, and U-100 insulin syringes to measure.
Alcohol swabs for the stoppers.
A sharps container for used needles.
A label or marker to write the date and the volume of water on the vial.
10
Side effects, safety and legal status
Tesamorelin's side effects are better documented than those of most peptides because of its approval. According to the FDA prescribing information, the most common side effects in trials were joint pain, injection-site redness and itching, pain in the arms or legs, swelling of the legs and muscle pain. More people stopped because of side effects on tesamorelin than on placebo (Falutz 2007).
Blood sugar: the prescribing information reports that more people on tesamorelin developed diabetes-range HbA1c than on placebo (5% vs 1%). Fasting glucose rose briefly in one trial (Stanley 2014).
Fluid retention: swelling, joint pain and carpal tunnel syndrome are listed warnings.
IGF-1 and cancer: IGF-1 is a growth factor. The label says the effects of long-term raised IGF-1 are unknown, and it should not be used by people with active cancer.
Allergic reactions and antibodies: hypersensitivity reactions occurred in trials, and about half of patients developed antibodies to tesamorelin.
Who should not use it (per the label): pregnant women, people with active cancer, and people whose pituitary or hypothalamus is damaged or removed.
Effects do not last: visceral fat came back after stopping (Falutz 2008). Long-term cardiovascular safety has not been established.
Research products: tesamorelin sold online as a research chemical is not the approved, quality-controlled drug.
Sport: growth hormone releasing factors are on the WADA prohibited list at all times.
FDA
FDA-approved in 2010 (now sold as Egrifta SV and Egrifta WR) for one indication: reducing excess abdominal fat in adults with HIV and lipodystrophy. Research products are not the approved drug.
WADA
Prohibited at all times (growth hormone releasing factors).
Status checked on
Oct 26, 2026
11
Storing Tesamorelin
Before mixing
Freeze-dried (lyophilised) peptide is the most stable form. It is usually kept refrigerated, or frozen for long storage, sealed and away from light.
Heat, moisture and light speed up degradation. Keep the vial in its box and avoid leaving it in a car or by a window.
After mixing
Keep the reconstituted vial refrigerated and away from light. Do not freeze it again: freezing and thawing a solution can break the peptide down.
How long a mixed vial stays good depends on the peptide and the diluent, and for most research peptides there is no published stability data. Follow the supplier's guidance and discard any vial that turns cloudy.
Pierce the stopper as few times as possible, and always with a new sterile needle after wiping it with alcohol.
Write the volume of water on the label (for example "2 mL"). Without it, the unit calculations cannot be checked later.
12
Questions about Tesamorelin
Is Tesamorelin FDA-approved?
FDA-approved in 2010 (now sold as Egrifta SV and Egrifta WR) for one indication: reducing excess abdominal fat in adults with HIV and lipodystrophy. Research products are not the approved drug.
What is the approved dose of Tesamorelin?
The FDA label of each approved drug sets its dosing; section 02 shows it with the source. It applies to the prescription drug used as prescribed, not to research products.
What doses of Tesamorelin have been studied?
Our library has 10 studies on Tesamorelin. The doses each one used are in section 04, next to the study. They are not dosing instructions.
How much Tesamorelin is in each syringe unit?
It depends on how much liquid is added to the vial. For a 10 mg vial with 2 mL, each U-100 unit holds 50 mcg. The reconstitution table and calculator work it out for other volumes.
Is tesamorelin approved for weight loss?
No. It is approved only to reduce excess abdominal fat in adults with HIV and lipodystrophy. The prescribing information states it is not indicated for weight loss because its effect on body weight is neutral.
Is the fat reduction permanent?
No. In the phase 3 trials, visceral fat returned after people switched from tesamorelin to placebo.
Has tesamorelin been studied in people without HIV?
Only in smaller trials, for example 53 people with type 2 diabetes and 152 older adults in a study of thinking skills. The large trials that led to approval were all in people with HIV.
How much bacteriostatic water goes into a 10 mg Tesamorelin vial?
There is no single correct volume: it only changes the concentration. For a 10 mg vial, 1 mL gives 10,000 mcg/mL, 2 mL gives 5,000 mcg/mL, 3 mL gives 3,333 mcg/mL. More water makes small amounts easier to measure; less water keeps volumes small. Whatever volume is used, write it on the label.
What does one unit on an insulin syringe mean?
On a U-100 syringe, 100 units = 1 mL, so one unit is 0.01 mL. How much peptide that holds depends on the concentration of the vial, which depends on how much water was added.
Can doses from animal studies of Tesamorelin be converted to people?
No. Animal doses are reported per kilogram for a different species, and scaling them to people is not reliable. That is why Upzo shows each study dose next to its study, unconverted.
How should Tesamorelin be stored?
Unopened freeze-dried vials are usually kept refrigerated and away from light. Once mixed, keep the vial refrigerated and follow the supplier's guidance on how long it lasts.
13
References
Metabolic Effects of a Growth Hormone-Releasing Factor in Patients with HIV. Falutz J, Allas S, Blot K, et al. New England Journal of Medicine. 2007;357:2359-2370. doi:10.1056/NEJMoa072375
A placebo-controlled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with abdominal fat accumulation. Falutz J, Allas S, Kotler D, et al. AIDS. 2005;19:1279-1287. doi:10.1097/01.aids.0000180099.35146.30
Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. Falutz J, Allas S, Mamputu JC, et al. AIDS. 2008;22:1719-1728. doi:10.1097/QAD.0b013e32830a5058
Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. Falutz J, Potvin D, Mamputu JC, et al. Journal of Acquired Immune Deficiency Syndromes. 2010;53:311-322. doi:10.1097/QAI.0b013e3181cbdaff
Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. Falutz J, Mamputu JC, Potvin D, et al. Journal of Clinical Endocrinology & Metabolism. 2010;95:4291-4304. doi:10.1210/jc.2010-0490
Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. Stanley TL, Feldpausch MN, Oh J, et al. JAMA. 2014;312:380-389. doi:10.1001/jama.2014.8334
Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Stanley TL, Fourman LT, Feldpausch MN, et al. The Lancet HIV. 2019;6:e821-e830. doi:10.1016/S2352-3018(19)30338-8
Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: A randomized, placebo-controlled trial. Clemmons DR, Miller S, Mamputu JC PLOS ONE. 2017;12:e0179538. doi:10.1371/journal.pone.0179538
Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Baker LD, Barsness SM, Borson S, et al. Archives of Neurology. 2012;69:1420-1429. doi:10.1001/archneurol.2012.1970
Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Badran AS, Helal A, Shata KS, et al. Obesity Research & Clinical Practice. 2026;20:2-12. doi:10.1016/j.orcp.2026.01.002
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Research and education only. Not medical advice. Many peptides on this site are not approved by the FDA for human use. Doses shown are the ones used in published studies and are not a recommendation. Talk to a licensed clinician before using any of them. Read the full disclaimer.
